Dynamic orthoscopic sensing

ABSTRACT

A dynamic sensing method and apparatus employs microelectromechanical systems (MEMS) and nanoelectromechanical (NEMS) surgical sensors for gathering and reporting surgical parameters pertaining to a drive mechanism of a surgical device, such as speed, rotation, torque and other characteristics of the surgical device. The surgical device employs or affixes the surgical sensor on or about a surgical device for detecting electromechanical characteristics during the surgical procedure. The surgical procedure disposes the medical device in the surgical field responsive to the drive mechanism of a shaver or other endoscopic instrument inserted in a surgical field defined by the surgical procedure.

BACKGROUND

Design and development of electronics has steadily been following adownsizing trend ever since Gordon Moore, cofounder of Intel®corporation, suggested in 1965 that the transistor density (hencecomputing power) of a given chip area doubles roughly every 24 months,in a somewhat prophetic assertion that has become widely known as“Moore's Law.” Medical devices and apparatus are no exception to thetrend of electronics miniaturization. Microelectronics are oftenemployed as sensors for providing diagnostic feedback on routine patientstatus, such as for sensing pulse, oxygen saturation, body temperature,and fetal vitals during childbirth.

During surgical procedures, sensing often extends to drive mechanismsfor surgical instruments, such as an orthoscopic shaver or cuttersystems. Orthoscopic surgical devices (and other endoscopic devices)perform minimally invasive procedures through apertures (holes) thatprovide access to a surgical field, in contrast to traditional opensurgery that requires an incision along the entire surgical field.Orthoscopic procedures, therefore, often occur in confined spaces insidethe abdominal cavity of a patient, using elongated probes of theorthoscopic surgical instruments. These instruments often requireprecise manipulation to navigate the narrow clearances of the surgicalfield. Accordingly, orthoscopic surgical devices and instruments avoidbulky and/or unwieldy design which may interfere with precisemanipulations of the surgeon.

SUMMARY

A dynamic sensing method and apparatus employs microelectromechanicalsystems (MEMS) and nanoelectromechanical (NEMS) surgical sensors forgathering and reporting surgical parameters pertaining to a drivemechanism of a surgical device, such as speed, rotation, torque andother characteristics of the surgical device. Micromechanical devices,in contrast to conventional electronics, are small machines adapted forphysical transitions such as movement of levers, gears, and transducers,in addition to computational execution, The surgical device employs oraffixes the surgical sensor on or about a surgical device for detectingelectromechanical characteristics during the surgical procedure. Thesurgical procedure disposes the medical device in the surgical fieldresponsive to the drive mechanism of a shaver or other endoscopicinstrument inserted in a surgical field defined by the surgicalprocedure.

Conventional sensors for providing diagnostic feedback for orthoscopicprocedures tend to crowd the surgical field and require additionaltethers (wired connections) to the instruments. The reduced size of thesurgical sensor allows nonintrusive placement in the surgical field,such that the sensor does not interfere with or adversely affect thedrive operation of the surgical device for which it is to measuresurgical parameters. The reduced size is also favorable to manufacturingcosts and waste for single use and disposable instruments which arediscarded after usage on a single patient.

In configurations disclosed below, a surgical device drive employs MEMSor NEMS surgical sensors to provide performance data and statistics tothe drive mechanism for use as feedback and control parameters to vary,for example, shaver speed and rotation proportional to a pump evacuatingthe surgical field. The surgical sensor is affixed or otherwise disposedon a “truck” or rotating hub of the shaver. A cutting blade extendsaxially from the truck for transferring rotary motion to a cutting edgeat an opposed end of the cutting blade. The truck rotates in response tothe drive mechanism for providing a cutting and/or extraction force tothe shaver, by rotating in a constant or oscillating manner to transfercutting force to the cutting edge. The surgical sensor detects rotation,speed, and torque of the shaver, for detecting speed indicative of anincision rate, and torque which may indicate an upper limit ofstructural stability of the truck and blade assembly.

Configurations herein are based, in part, on the observation thatconventional approaches employ RFID (Radio Frequency Identification)tags on surgical tools and equipment for tracking during a surgicalprocedure. While RFIDs can be fabricated to be small and passive (i.e.externally powered by the triggering signal), computation and executionpower is limited. Unfortunately, therefore, conventional approaches toparameter sensing suffer from the shortcoming that response is typicallylimited to identification of the device or instrument on which the RFIDis affixed, and information other than identity is unavailable, due tolimited computational ability that may be encoded on an RFID.

Accordingly, configurations herein substantially overcome the abovedescribed shortcomings by providing an unobtrusive sensor disposed on asurgical device responsive to a drive mechanism for sensing dynamicattributes such as speed, rotation and torque and for transmitting thesensed attributes via a wireless interface to a drive source forresponsive control. The wireless interface allows affixation of thesurgical sensor to a rotating or moving component of the surgicaldevice, and the micromechanical nature allows placement in anoninterfering location that does not adversely affect surgical deviceoperation.

In further detail, the method provides dynamic surgical feedback duringa surgical or therapeutic procedure by identifying a sensory area on asurgical device, such that the sensory area is adapted to receive anintegrated micromechanical device and responsive to sensedelectromechanical stimuli during a surgical procedure. The surgicaldevice is coupled to a drive source for performing surgicalmanipulations, and the integrated micromechanical device is affixed tothe sensory area for detecting surgical parameters dynamically duringthe surgical procedure. The integrated micromechanical device(micromechanical device) maintains wireless communication with acontroller responsive to the integrated micromechanical device fordynamically receiving the detected surgical parameters from theintegrated micromechanical device during the surgical procedure, andplacement in a non-interfering sensory area provides that the sensedsurgical parameters are unaffected by the presence of themicromechanical device due to unobtrusive placement of the integratedmicromechanical device at the sensory area.

In a particular configuration, the claimed approach has particularutility in an endoscopic procedure such as a knee joint surgery,discussed herein as an example application. In a medical deviceenvironment, the method controls a surgical extraction device, such as ashaver, and including an integrated micromechanical device configuredfor rotational sensing, and establishes a wireless connection from themicromechanical device to a controller for sending sensed rotationalparameters. An attachment mechanism affixes the integratedmicromechanical device to a rotary hub for driving a surgical blade, inwhich the rotary hub is responsive to a drive source for rotating thesurgical blade for cutting and extraction of surgical matter. As therotary hub restricts physical connections due to movement (rotation),the wireless connection mitigates the need for physical tetheredconnections. The surgeon disposes the surgical blade in a surgical fieldfor performing therapeutic manipulations from rotation of the surgicalblade, and the micromechanical device senses, based on the rotation ofthe hub, the rotational parameters caused by centrifugal forces exertedon the micromechanical device. The micromechanical device sends thesensed rotational parameters to a controller for deriving surgicalparameters, in which the controller is coupled to a pump and configuredto control the pump in response to the derived surgical parameters,therefore providing proportional control for the pump in response toshaver activity.

Alternate configurations of the invention include a multiprogramming ormultiprocessing computerized device such as a multiprocessor, controlleror dedicated computing device or the like configured with softwareand/or circuitry (e.g., a processor as summarized above) to process anyor all of the method operations disclosed herein as embodiments of theinvention. Still other embodiments of the invention include softwareprograms such as a Java Virtual Machine and/or an operating system thatcan operate alone or in conjunction with each other with amultiprocessing computerized device to perform the method embodimentsteps and operations summarized above and disclosed in detail below. Onesuch embodiment comprises a computer program product that has anon-transitory computer-readable storage medium including computerprogram logic encoded as instructions thereon that, when performed in amultiprocessing computerized device having a coupling of a memory and aprocessor, programs the processor to perform the operations disclosedherein as embodiments of the invention to carry out data accessrequests. Such arrangements of the invention are typically provided assoftware, code and/or other data (e.g., data structures) arranged orencoded on a computer readable medium such as an optical medium (e.g.,CD-ROM), floppy or hard disk or other medium such as firmware ormicrocode in one or more ROM, RAM or PROM chips, field programmable gatearrays (FPGAs) or as an Application Specific Integrated Circuit (ASIC).The software or firmware or other such configurations can be installedonto the computerized device (e.g., during operating system execution orduring environment installation) to cause the computerized device toperform the techniques explained herein as embodiments of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other objects, features and advantages of theinvention will be apparent from the following description of particularembodiments of the invention, as illustrated in the accompanyingdrawings in which like reference characters refer to the same partsthroughout the different views. The drawings are not necessarily toscale, emphasis instead being placed upon illustrating the principles ofthe invention.

FIG. 1 is a context diagram of a medical device environment suitable foruse with configurations disclosed herein;

FIG. 2 is a flowchart of dynamic parameter sensing as disclosed herein;

FIG. 3 is a diagram of sensor deployment in the environment of FIG. 1;and

FIGS. 4-6 are a flowchart of endoscopic sensory arrangements during asurgical procedure.

DETAILED DESCRIPTION

Depicted below is an example configuration of a medical deviceenvironment employing dynamic feedback via micromechanical surgicalsensors. In the example shown, the surgical device is a surgical shaverresponsive to a drive source for providing rotational movement forexcising and removing surgical material such as bone and tissue from thesurgical field. The surgical sensor is affixed to a so-called truck, orrotating hub, responsive to the drive source. A cutting edge at the endof the cutting blade rotates or oscillates to extract the surgicalmaterial, and a hollow interior of the tubular blade allows evacuationby a pump, also controlled by the drive source.

FIG. 1 is a context diagram of a medical device environment 100 suitablefor use with configurations disclosed herein. Referring to FIG. 1, themedical device environment 100 employs an integrated micromechanicaldevice (micromechanical device) 110 for placement within the surgicalenvironment, such as in a shaver 130, shown as 110-1 or at a surgicalfield 154 of the patient 132, shown as 110-2 (110 generally). Themicromechanical device 110, in a particular configuration, is a MEMS orNEMS device and maintains a wireless connection 112 to a drivecontroller 120 or other centralized controller responsive to signals 122to (122-1) and from (122-2) a wireless antenna 124. The micromechanicaldevice 110 includes a receiver 115 responsive to the signals 122-2 fromthe antenna 124 for requesting sensing of surgical parameters, and atransmitter 113 configured to transmit the sensed surgical parametersback to the controller 120 via signals 122-1, and may include othersensing, computation, and power components 117. The micromechanicaldevice 110 may be passive, such that the signals 122-2 also providepower to the device 110, and is sufficiently small such that receivedsignals 122-2 permit operation and transmission of sensed parameters122-1, and the micromechanical device 110 may have other sensory areas,processing functions or mechanical features responsive to the signal122-2.

Placement of the micromechanical device 110 is such that it directlysenses surgical parameters such as speed, rotation and torque, and mayinclude affixation to the interior of a surgical shaver 130, shown asmicromechanical device 110-1, or may operate directly within thesurgical site 154. The micromechanical device 110, once disposed,activates from a signal 122-2 from the controller 120, and performssensing, computation and transmission tasks for returning the sensedsurgical parameters 122-1. The shaver 130 configuration affixes themicromechanical device 110-1 to the truck or hub 180 which is theninserted into a surgical site for surgical cutting and evacuation,discussed further below with respect to FIG. 3.

FIG. 2 is a flowchart of dynamic parameter sensing as disclosed herein.In the surgical device environment 100, the disclosed method ofcontrolling a surgical appliance includes, at step 200, identifying asensory area on a surgical device 130, such that the sensory area 131 isresponsive to sensed electromechanical stimuli during a surgicalprocedure. The surgical device 130 couples to a drive source 120 forperforming surgical manipulations such as drilling or pumping. In arotary device such as the example shaver 130, for example, the sensoryarea 131 may be on a rotating part subject to centrifugal forces fromthe drive source 120 during operation. Various sensing capabilities maybe employed in the micromechanical device 110-1, such as variableresistance, pressure sensing, gyroscopic and strain gauge sensing, toname several.

An attachment mechanism affixes the integrated micromechanical device110-1 to the sensory area 131 for detecting surgical parametersdynamically during the surgical procedure, as shown at step 201. Theattachment mechanism may be any suitable affixation, such as pins, glue,solvent welding, or may be a feature of the surgical instrumentfabrication, such as a cavity or pocket formed during casting, forexample.

The micromechanical device 110 maintains wireless communication with thedrive controller 120 for dynamically receiving the detected surgicalparameters as signals 122-1 from the integrated micromechanical device110 during the surgical procedure, as depicted at step 202. Location andsize of the device 110 is such that the surgical parameters areunaffected by the presence of the integrated micromechanical device dueto unobtrusive placement of the integrated micromechanical device at thesensory area 131.

FIG. 3 is a diagram of sensor deployment in the environment of FIG. 1.Referring to FIGS. 1 and 3, an example arrangement of micromechanicaldevice 110 deployment in an endoscopic knee procedure is depicted. Asurgeon disposes the shaver 130 through an endoscopic aperture 150 inthe knee 152 of a patient. The shaver 130 extends through skin and softtissue into a surgical void 154 between the femur 156 and tibia 158. Theshaver 130 includes a drive connection 160, for coupling to a drive port162 of the controller 120 via a drive cable 182. The drive connection160 may receive electric, pneumatic, hydraulic, or other suitable drivemedium for powering the hub 180 and attached surgical blade 162 andcutting edge 164. The shaver 130 also includes a suction port 170 forcoupling to an evacuation port 172 via a tube set 174. The drivecontroller 120 applies suction (typically via a surgical pump) forevacuating surgical material from the shaver via the hollow core 176 ofthe surgical blade 162. Alternatively, a separate pump may be employeddistinct from the drive controller 120 powering the shaver 130. Theprocedure may also include one or more cannulas 140 having amicromechanical device 110-3 affixed to the interior of a delivery tube160 of the cannula 140 for sensing pressure, flow and temperature ofsaline pumped through the cannula delivery tube 160, and for additionalirrigation or evacuation (suction) of the surgical site

FIGS. 4-6 are a flowchart of endoscopic sensory arrangements during asurgical procedure. Referring to FIGS. 1 and 3-6, a method ofcontrolling a surgical extraction device such as a shaver 130 includesconfiguring an integrated micromechanical device 110-1 for rotationalsensing, as depicted at step 300. In the example arrangement, thisincludes configuring the micromechanical device 110-1 for sensing atleast one of speed, rotation or torque of the surgical device, in whichthe integrated micromechanical device comprises at least one of a straingauge, miniature gyro or a pressure sensor/transducer, as disclosed atstep 301. Various sensing and computational capabilities may beconfigured or fabricated on the micromechanical device 110. Inparticular, rotational sensing due to centrifugal force, or detectingalternating orientations through a gravitational field, may indicaterotation. The micromechanical device 110 is also is equipped forestablishing a wireless connection 122-1 from the integratedmicromechanical device 110-1 to a controller 120 for sending sensedrotational parameters, as depicted at step 302.

The MEMS equipped shaver 130 affixes the integrated micromechanicaldevice 110 to a sensory area 131 such as a rotary hub 180 for driving asurgical blade, as disclosed at step 303, in which the rotary hub 180 isresponsive to a drive source or controller 120 for rotating the surgicalblade 162 for cutting and extraction of surgical matter. The wirelesscapability provides for gathering of surgical parameters despite therotary hub 180 restricting physical connections due to movement(rotation). In the shaver 130 example shown, the sensory area 131 is ona rotating portion of the surgical device (hub of shaver 130), andaffixation disposes the integrated micromechanical device 110 on therotating portion 180, as depicted at step 304.

The surgical blade 162 extending from the hub 180 includes a hollowshaft or bore 176 coupled to a cutting tip 164, such that the cuttingtip 164 has a cutting edge parallel to an axis of the hollow shaft andresponsive to the rotation for exerting a cutting force normal to theedge of the blade 162, as disclosed at step 305. The micromechanicaldevice 110 therefore employs no physical connection to a recordingdevice for recording the surgical parameters due to the rotation of thehub 180, as shown at step 306, as dynamic movement of the sensory area131 prohibits physical connection to a recording device for recordingsurgical parameters, as depicted at step 307. Rather, gathering surgicalparameters is facilitated from unobtrusive placing of a wirelesscoupling (i.e. transmitter 113) to a controller of the surgical device130 that does not affecting rotation or flow of surgical material viathe device 130, as disclosed at step 308.

In the course of a surgical or therapeutic procedure, a surgeon disposesthe surgical blade 162 into the surgical field 154 for performingtherapeutic manipulations from rotation of the surgical blade 162, asshown at step 309. This includes disposing the micromechanical device110 on a truck 180 adapted to couple the surgical blade 162 to the drivesource 120 and responsive to the rotation for exerting a cutting forceon the cutting edge 164 via the surgical blade 162 via, as depicted atstep 310. The drive source 120 rotates the rotating portion 180 via adrive cable 182 from the drive controller 120 such that the sensory area131 experiences forces detectable by the micromechanical device 110-1,as disclosed at step 311.

The micromechanical device 110 senses, based on the rotation of the hub180, the rotational parameters caused by centrifugal forces exerted onthe micromechanical device 110-1, as shown at step 312. The sensory area131 restricts physical connections due to movement of the surgicaldevice 130 responsive to the drive source 120, as depicted at step 313,such as rotation of the hub 180 or other drive mechanism. Alternateconfigurations may deploy various sensing capabilities on themicromechanical device 110. A strain gauge may be employed to detecttorque by sensing surface variations on the hub 180 for sensingexcessive and damaging force that could fracture the hub 180.Centrifugal or gravitational variations may be sensed by a pressuresensitive resistor or gyroscope, for example. In the particular shaverarrangement shown, the micromechanical device 110-1 sends the sensedrotational or other sensed parameters to the controller 120 for derivingthe surgical parameters, in which the controller 120 is coupled to apump and configured to control the pump in response to the derivedsurgical parameters, as depicted at step 314. In such a configuration,the drive controller 120 varies pressure exerted by the pump in responseto the derived surgical parameters, as disclosed at step 315, to providea level of suction pressure proportional to the evacuation of surgicalmaterial resulting from the speed and cutting force of the surgicalblade 162. prevailing

Conventional approaches are shown by U.S. Publication No. 2007/0078484,to Talarico et al. (Talarico '484), which discloses a surgical graspercomprising a handle and two jaws operably connected to and actuated bythe handle. A sensor is located on an inner surface of one or both ofthe jaws for direct measurement of an amount of pressure or force beingapplied with the grasper, referring to paragraph [0006]. While Talarico'484 suggests MEMS based sensors at paragraph [0047]-[0048], the sensorsare for detecting pressure or force between the jaws. In contrast to theproposed approach, there is no showing, teaching, or disclosure ofrotary based parameters such as torque, speed or rotation. Further, suchrotary parameters would be inapplicable to the linear forces pertainingto the closure of the jaw surfaces.

Another application, U.S. Publication No. 2008/0167672 by Giordano(Giordano '672), teaches a surgical instrument comprising at least onesensor transponder, such as endoscopic or laparoscopic surgicalinstruments. Giordano '672 is directed to surgical instruments wheresome feature of the instrument, such as a free rotating joint, preventsor otherwise inhibits the use of a wired connection to the sensor(s), asdiscussed at [0033]. While Giordano '672 refers to MEMS technology, the'672 publication only employs sensors in the articulated jaws of the endeffector 12, as disclosed at paragraph [0057], and makes no suggestionof continued rotation as in a shaft drive. Accordingly, Giordano '672does not show, teach or disclose MEMS sensors disposed in a rotaryconfiguration or coupling for sensing and transmitting operationalparameters related to the rotating movement, in contrast to the proposedapproach.

U.S. Publication No. 2005/0131390 ('390) teaches a surgical stapler withan end effector including a staple cartridge assembly, and an anviloperatively associated with the staple cartridge, such that the staplecartridge and the anvil are movably connected to one another to bringone into juxtaposition relative to the other. Each of the staplecartridge and the anvil define tissue contacting surfaces and the MEMSdevice is operatively connected to the tissue contacting surface of thestaple cartridge and the tissue contacting surface of the anvil. Aplurality of MEMS devices are connected to the surgical instrument, andthe MEMS devices are configured and adapted to measure distance betweenthe tissue contacting surface of the staple cartridge assembly and thetissue contacting surface of the anvil, as discussed at paragraph[0014].

The disclosed MEMS devices in the '390 application are configured andadapted to measure at least one of the amount of pressure applied totissue and the thickness of tissue clamped between the tissue contactingsurface of the staple cartridge assembly and the tissue contactingsurface of the anvil, discussed at [0015]. In contrast to the proposedapproach, however, there does not appear to be any disclosure of sensorsapplied to rotary or rotational movement, nor of associated feedback ofoperational data or parameters relating to rotary motion.

Those skilled in the art should readily appreciate that the programs andmethods for measuring surgical parameters as defined herein aredeliverable to a user processing and rendering device in many forms,including but not limited to a) information permanently stored onnon-writeable storage media such as ROM devices, b) informationalterably stored on writeable non-transitory storage media such asfloppy disks, magnetic tapes, CDs, RAM devices, and other magnetic andoptical media, or c) information conveyed to a computer throughcommunication media, as in an electronic network such as the Internet ortelephone modem lines. The operations and methods may be implemented ina software executable object or as a set of encoded instructions forexecution by a processor responsive to the instructions. Alternatively,the operations and methods disclosed herein may be embodied in whole orin part using hardware components, such as Application SpecificIntegrated Circuits (ASICs), Field Programmable Gate Arrays (FPGAs),state machines, controllers or other hardware components or devices, ora combination of hardware, software, and firmware components.

While the system and method of measuring surgical parameters has beenparticularly shown and described with references to embodiments thereof,it will be understood by those skilled in the art that various changesin form and details may be made therein without departing from the scopeof the invention encompassed by the appended claims.

What is claimed is:
 1. A method of controlling a surgical extraction device comprising: configuring an integrated micromechanical device for rotational sensing; establishing a wireless connection from the integrated micromechanical device to a controller for sending sensed rotational parameters; affixing the integrated micromechanical device to a rotary hub for driving a surgical blade, the rotary hub responsive to a drive source for rotating the surgical blade for cutting and extraction of surgical matter; the rotary hub restricting physical connections due to movement; disposing the surgical blade in a surgical field for performing therapeutic manipulations from rotation of the surgical blade; sensing, based on the rotation of the hub, the rotational parameters caused by centrifugal forces exerted on the integrated micromechanical device; and sending the sensed rotational parameters to a controller for deriving surgical parameters, the controller coupled to a pump and configured to control the pump in response to the derived surgical parameters.
 2. The method of claim 1 further comprising varying a pressure exerted by the pump in response to the derived surgical parameters.
 3. In a surgical device environment, a method of controlling a surgical appliance comprising: identifying a sensory area on a surgical device, the sensory area adapted to receive an integrated micromechanical device and responsive to sensed electromechanical stimuli during a surgical procedure, the surgical device coupled to a drive source for performing surgical manipulations and adapted for insertion into an endoscopic site; affixing the integrated micromechanical device to the sensory area for detecting surgical parameters dynamically during the surgical procedure; and maintaining wireless communication with a controller, the controller responsive to the integrated micromechanical device for dynamically receiving the detected surgical parameters from the integrated micromechanical device during the surgical procedure, the surgical parameters unaffected by the presence of the integrated micromechanical device due to unobtrusive placement of the integrated micromechanical device at the sensory area.
 4. The method of claim 3 wherein the sensory area is on a rotating portion of the surgical device, further comprising disposing the integrated micromechanical device on the rotating portion; and rotating the rotating portion from the drive source such that the sensory area experiences forces detectable by the integrated micromechanical device.
 5. The method of claim 4 wherein disposing further comprises disposing the integrated micromechanical device on a truck adapted to couple a surgical blade to the drive source and responsive to the rotation for exerting a cutting force on the surgical blade.
 6. The method of claim 5 wherein the surgical blade includes a hollow shaft coupled to a cutting tip, the cutting tip having a cutting edge parallel to an axis of the hollow shaft and responsive to the rotation for exerting a cutting force normal to the edge of the blade.
 7. The method of claim 3 wherein the integrated micromechanical device employs no physical connection to a recording device for recording surgical parameters.
 8. The method of claim 7 wherein dynamic movement of the sensory area prohibits physical connection to a recording device for recording surgical parameters.
 9. The method of claim 8 wherein affixing includes unobtrusive placement employing a wireless coupling to a controller of the surgical device and not affecting rotation or flow of surgical material via the device.
 10. The method of claim 3 wherein the sensory area restricts physical connections due to movement of the surgical device responsive to the drive source.
 11. The method of claim 10 further comprising configuring the integrated micromechanical device for sensing at least one of speed, rotation or torque of the surgical device, the integrated micromechanical device comprising at least one of a strain gauge, miniature gyro or a pressure sensor/transducer.
 12. A surgical appliance comprising: A sensory area on a surgical device, the sensory area adapted to receive an integrated micromechanical device and responsive to sensed electromechanical stimuli during a surgical procedure, the surgical device coupled to a drive source for performing surgical manipulations; an attachment mechanism for affixing the integrated micromechanical device to the sensory area for detecting surgical parameters dynamically during the surgical procedure, wherein the sensory area is on a rotating portion of the surgical device adapted to receive the integrated micromechanical device on the rotating portion and responsive to rotation from a drive source for rotating the rotating portion from the drive source such that the sensory area experiences forces detectable by the integrated micromechanical device; and a wireless transmitter for maintaining wireless communication with a controller for dynamically receiving the detected surgical parameters from the integrated micromechanical device during the surgical procedure, the surgical parameters unaffected by the presence of the integrated micromechanical device due to unobtrusive placement of the integrated micromechanical device at the sensory area.
 13. The surgical appliance of claim 12 wherein the integrated micromechanical device is disposed on a truck adapted to couple a surgical blade to the drive source and responsive to the rotation for exerting a cutting force on the surgical blade.
 14. The surgical appliance of claim 13 wherein the surgical blade includes a hollow shaft coupled to a cutting tip, the cutting tip having a cutting edge parallel to an axis of the hollow shaft and responsive to the rotation for exerting a cutting force normal to the edge of the blade.
 15. The surgical appliance of claim 12 wherein the integrated micromechanical device is devoid of a physical connection to a recording device for recording surgical parameters.
 16. The surgical appliance of claim 15 wherein dynamic movement of the sensory area prohibits physical connection to a recording device for recording surgical parameters.
 17. The surgical appliance of claim 16 wherein affixing includes unobtrusive placement employing a wireless coupling to a controller of the surgical device and not affecting rotation or flow of surgical material via the device, the sensory area restricting physical connections due to movement of the surgical device responsive to the drive source.
 18. The surgical appliance of claim 17 wherein the integrated micromechanical device includes structures for sensing at least one of speed, rotation or torque of the surgical device.
 19. The integrated micromechanical device of claim 17 further comprising at least one of a strain gauge, miniature gyro or a pressure sensor/transducer.
 20. In a surgical device environment, a method of controlling a surgical appliance comprising; identifying a sensory area on a surgical device, the sensory area adapted to receive an integrated micromechanical device and responsive to sensed electromechanical stimuli during a surgical procedure, the surgical device coupled to a drive source for performing surgical manipulations; affixing the integrated micromechanical device to the sensory area between the drive source and a surgical site for detecting surgical parameters dynamically during the surgical procedure; detecting centrifugal forces applied to the sensory area of the surgical device; and maintaining wireless communication with a controller, the controller responsive to the integrated micromechanical device for dynamically receiving the detected surgical parameters from the integrated micromechanical device during the surgical procedure, the surgical parameters unaffected by the presence of the integrated micromechanical device due to unobtrusive placement of the integrated micromechanical device at the sensory area.
 21. The method of claim 20 further comprising detecting alternating gravitational forces indicative of rotary movement applied to the sensory area of the surgical device. 